title: [Third replacement of the tricuspid valve in combined aortic-tricuspid defect].
abstract: The implantation of valvular prostheses in tricuspid position is problematic due to the slow blood flow in the low-pressure system with the risk of valvular thromboses. Today there are prostheses with supportable low transvalvular gradients; nevertheless, the risk of valvular thromboses is, in spite of anticoagulation, increased by using mechanical prostheses in tricuspid position. We report on a 51-year-old woman in whom a dysfunction of the Starr Edwards ball prosthesis 15 years after its implantation in the tricuspid position was diagnosed. The prosthesis, which was unable to function due to connective tissue proliferation, was replaced by a St. Jude Medical prosthetic valve, which also presented a disturbed function a few days after the implantation. Because of a suspected valve thrombosis the patient was treated with rt-PA-lysis which proved to be ineffective. Thus it was inevitable to implant a third tricuspid valve; this time a bioprosthesis was used.
authors.affiliation: Innere Medizin III (Kardiologie), Universitätskliniken des Saarlandes, Homburg-Saar.
authors.forename: S
authors.initials: S
authors.lastname: Spitzer
authors.forename: H
authors.initials: H
authors.lastname: Schwerdt
authors.forename: W
authors.initials: W
authors.lastname: Vogel
authors.forename: H P
authors.initials: HP
authors.lastname: Stoll
authors.forename: G
authors.initials: G
authors.lastname: Fröhlig
authors.forename: I
authors.initials: I
authors.lastname: Volkmer
authors.forename: G
authors.initials: G
authors.lastname: Kalweit
authors.forename: H
authors.initials: H
authors.lastname: Schieffer
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000601:surgery; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D014261:Tricuspid Valve / Q000601:surgery*; D014264:Tricuspid Valve Stenosis / Q000150:complications* / Q000601:surgery
vernacular_title: Trikuspidalklappen-Drittersatz bei kombiniertem Aorten-Trikuspidal-Vitium.